NHS post election : notes from Dr. John Puntis
NHS became a major issue (thanks to campaigners) in election – forced Johnson to make promises. Roy Lilley came up with a list of these. They are already being broken!
Queen’s speech enshrined promise of extra money in law – but this funding is inadequate. NHS Providers Chief Exec Chris Hopson – if rate had gone up as before 2010, budget would now be £35m higher.
Government says giving “£34bn in cash terms” over 5 years – first year’s extra frontline £5.5bn and by 2023/24 extra £30.5bn – but NHS needs money now, and has lost out on underinvestment.
Note also that “£34bn in cash terms” if adjusted for inflation and cost pressures, the government’s own figures show it will be worth only £20.5 bn in real terms.
Real budget for NHS in 2024 will be way below what is needed (increased population, more chronic illness, new treatments) – Trusts now in debt of £14bn – BMA estimates £6.2bn short a year on top of existing deficits.
November 2019: 2.1 million A&E attendances – 5.2% increase from last year; 94.9% bed occupancy – waiting list grown to 4.2 million – worst ever performance against 4 hour standard
Will continue to impact on mental health, GP and community services.
Social care – no solution; “cross party consensus”
6000 new GPs not included in legally binding proposals; promise of 5000 made in 2015 by Hunt and reiterated 5 times + overall reduction in 1000 WTE. 50k nurses (18k already working!)
Nursing bursary has not been restored – it is £5k annual maintenance grant – still have to pay £9k tuition fees (nurse applications fell by 30% after abolition
12.5% of NHA staff are foreign nationals; “new visa to ensure fast track entry” but massive fall in recruitment from EU; £400 for visa plus £625/person immigration health charge annually
Scrap hospital car parking (less money for hospitals) – only “for those in greatest need” (abolished already in Scotland and Wales)
“NHS Long term plan Bill” – no explanation how LTP can be implemented, but stripping away accountability and bringing in Integrated Care Provider contracts with scope for major private involvement
“40 new hospitals” – only 6 will get beyond drawing board by 2024; 21 seed funding; 20 some money for upgrades and maintenance, but 100 that have asked for funds rejected
If anyone really believed that Johnson’s “new” Conservative government, following nine years of Conservative governments, was going to pump big money into the NHS and tackle the problems that are increasingly in the headlines, they will have five miserable years to reflect on how wrong they were